US4815461A - Surgical laser backstop instrument - Google Patents

Abstract

A surgical laser backstop instrument comprising a rod, a backstop pivotally mounted to one end of the rod, and a backstop adjustment mechanism mounted to the other end of the rod. The backstop is comprised of a non-reflective material. The backstop adjustment mechanism controls the movement of the backstop. The backstop is a flat section of titanium-coated material and is movable between a position longitudinally aligned with the axis of the rod and a position transverse to the axis of the rod. The backstop adjustment mechanism comprises a body connected to the other end of the rod, a line fastened at one end to the backstop and extending through the rod, and a movement actuator mechanism connected to the other end of the line for controlling the pivotal movement of the backstop. This movement actuator mechanism includes a knob rotatably mounted to the body, a rack assembly placed within the body and connected to the end of the line, and a pinion gear engaging the rack assembly and connected to the knob such that rotational movement of the knob causes movement of the rack assembly.

Description

FIELD OF THE INVENTION

The present invention relates to surgical laser backstops. More particularly, the present invention relates to the use of lasers in a surgical procedure known as laparoscopy.

BACKGROUND OF THE INVENTION

A relatively new area of surgical procedure is known as laparoscopy. Laparoscopy is the visual examination of the interior of the abdomen by the use of a laparoscope. A laparoscope is a long slender instrument for insertion through the abdominal wall. Through appropriate optical techniques, the surgeon is able to view the interior of the peritoneal cavity by proper use of the laparoscope.

This laparoscopy procedure is facilitated by the use of a trocar instrument. After the trocar instrument is inserted into the abdominal wall at two separate points, the pointed portion of the trocar is removed and a sleeve portion remains. The sleeve portion extends through the abdominal wall and communicates with the interior of the peritoneal cavity. In this surgical procedure, one of the trocar sleeves is placed for the purpose of allowing the insertion of the laparoscope. The other of the trocar sleeves is in position to allow the surgeon to insert an instrument for the manipulation of the internal organs for better viewing with the laparoscope.

After the surgeon has found adhesions during his use of laparoscopy, it is necessary to remove these adhesions by one technique or another. A recent development in laparoscopy has been the use of a laser beam for the removal of these adhesions. Typically, the laser is connected to and aligned with the laparoscope. The laser beam will have a suitable power for the removal of the adhesions found within the peritoneal cavity.

In order for a laser to be appropriately utilized in such surgery, it is necessary to have a laser backstop positioned adjacent to the adhesions being removed. This backstop may be inserted through the trocar sleeve and, through the use of the laparoscope, is positioned on the opposite side of the adhesion from the laser beam. It is important that the laser be directed to the appropriate location and that the laser does not cause any damage to internal organs other than to the adhesions.

At present, such laser backstops comprise a long slender rod with a fixed, longitudinally aligned backstop portion. Typically, adhesions will have a multitude of varied configurations. Many times, it is difficult to position the backstop so as to fully remove the adhesion. Since a fixed backstop does not "wrap around" or otherwise follow the contour of the adhesion, it is difficult to properly guide the laser beam so as to fully remove the adhesion.

Another problem with this laser surgery is that smoke, produced by the destruction of the adhesion, will interfere with the viewing capability of the laparoscope. Since the smoke does not dissipate immediately, the surgeon must proceed with the laser surgery even through viewing in somewhat obstructed.

It is an object of the present invention to provide a laser backstop instrument which is adjustable to follow the contour of the adhesion and to aid in the manipulation of the instrument in the peritoneal cavity.

It is another object of the present invention to provide a laser backstop instrument that assists in the removal of smoke during laser surgery.

It is still a further object of the present invention to provide a laser backstop that the surgeon can suitably manipulate to assist in the surgical procedure.

These and other objects and advantages of the present invention will become apparent from a reading of the attached specification and appended claims.

SUMMARY OF THE INVENTION

The present invention is a surgical laser backstop instrument that comprises a rod, a backstop pivotally mounted to one end of the rod, and a backstop adjustment mechanism mounted to the other end of the rod. The backstop is comprised of a non-reflecting material. The backstop adjustment mechanism serves to control the movement of the backstop relative to the position of the rod.

The rod is coated with a non-reflective material. Specifically, the rod is coated with titanium. The rod has a length of greater than twelve inches (12") and a diameter of greater than thirteen sixty-fourths of an inch (13/64"). Additionally, the rod has an evacuation bore extending longitudinally therethrough.

The backstop is a flat section of titanium-coated material having a width not greater than the diameter of the rod. This backstop is movable between a position in which the backstop is aligned with the longitudinal axis of the rod and a position in which the backstop is transverse to the longitudinal axis of the rod. The backstop extends outwardly from the end of the rod a distance of greater than seven-tenths of an inch (7/10").

The backstop adjustment mechanism comprises a body connected to the opposite end of the rod. A line is fastened to one end of the backstop and extends through a bore in the rod. A movement actuator mechanism is connected to the other end of the line for controlling the pivotal movement of the backstop. The body comprises a barrel having an aperture extending at least partially therethrough. This barrel is fixedly attached to the end of the rod. The line comprises a wire connected at one end to the movement actuator mechanism and at the other end to the backstop. This wire extends through the bore in the rod. Specifically, a pair of wires extends through parallel bores in the rod.

The movement actuator mechanism comprises a knob, a rack assembly, and a pinion gear. The knob is rotatably mounted to the body and serves to manually control the position of the backstop. The rack assembly is placed within the body and is connected to the other end of the line. The pinion gear engages the rack assembly and is connected to the knob such that a rotational movement of the knob causes a corresponding rotation of the pinion gear. The rotation of the pinion gear causes the rack assembly to be movable relative to the rotation of the pinion gear.

The present invention also includes smoke evacuation means. This smoke evacuation means comprises a vacuum communicating with the end of the evacuation bore in the rod. The vacuum serves to draw smoke through the evacuation bore. One end of the evacuation bore is generally adjacent the backstop. The body includes an aperture extending therethrough which is a continuation of this evacuation bore from the rod. As smoke is generated by the vaporization of tissue by the laser, the smoke is drawn from the peritoneal cavity, through the evacuation bore, and toward the vacuum pump.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a top view of the surgical laser backstop instrument in accordance with the preferred embodiment of the present invention.

FIG. 2 is a side view showing the surgical laser backstop instrument in accordance with the preferred embodiment of the present invention.

FIGUGRE 3 is a sectional view showing the rack assembly contained within the body of the instrument.

FIG. 4 shows the pinion gear and knob as contained within the body of the instrument.

FIG. 5 is a cross-sectional side view showing the surgical laser backstop instrument, along with the smoke evacuation bore, in accordance with an alternative embodiment of the present invention.

FIG. 6 is an end view of the backstop portion of the alternative embodiment of the present invention.

DETAILED DESCRIPTION OF THE INVENTION

Referring to FIG. 1, there is shown at 10, the surgical laser backstop instrument in accordance with the preferred embodiment of the present invention. The surgical laser backstop instrument 10 comprises arod 12, abackstop 14, and a backstop adjustment mechanism 16.

Rod 12 has a generally cylindrical shape and extends for a distance of greater than twelve inches (12").Rod 12 also has a diameter of thirteen sixty-fourths of an inch (13/64") or greater. In surgery, these dimensions are rather important. Therod 12 should have a length greater than twelve inches (12") because such a length is important in carrying out proper surgical procedures. In order to properly penetrate and explore the peritoneal cavity, the rod should have a length of greater than twelve inches (12"). The diameter ofrod 12 is also important since the diameter should be a close, nearly air-tight, match of the interior diameter of the trocar sleeve. Insofar as it is necessary to inflate the peritoneal cavity in order to properly use the laparoscope, it is also necessary, to some extent, to maintain an air-tight seal between the instrument and the interior of the trocar sleeve. If the rod had a dimension of less than thirteen sixty-fourths of an inch (13/64"), then there would be less than an airtight seal. This would cause the peritoneal cavity to deflate and to hamper the surgical procedure.

Rod 12 should be coated with a non-reflective material. Specifically, the rod should be coated with titanium material. It is important that a rod be coated with a laser non-reflective material since as any reflection caused by the interaction of the laser beam upon the rod could deflect the laser beam and cause potential damage to organ within the peritoncal cavity.Rod 12 hasbackstop 14 pivotally connected at one end and has the backstop adjustment mechanism 16 mounted at the other end. As will be described hereinafter,rod 12 may also include an evacuation bore which extends longitudinally therethrough.

Backstop 14 is pivotally mounted at 18 torod 12.Backstop 14 is coated with a laser non-reflective material. Specifically, this laser non-reflective material is titanium, or a titanium-coated material.Backstop 14 has the width not greater than the diameter ofrod 12. Since the instrument 10 must be inserted through the trocar sleeve, the width ofbackstop 14 must be less than the diameter ofrod 12 so as to enhance the ability to insert the instrument 10 through the trocar sleeve and to enhance the ability to remove the instrument 10 from the trocar sleeve.Backstop 14 extends outwardly for a distance of greater than seven-tenths of an inch (7/10") from theend 18 ofrod 12. It may be also possible to have a longer backstop for use in situations where the laser beam must be directed to a longer adhesion, or along a longer path. The length of the backstop is a balance between the convenience of use, the requirements of the laser operation, and the ability to manipulate the instrument in the peritoneal cavity.

As shown in FIG. 1, the backstop adjustment mechanism 16 includes abody 20 which is connected to theend 22 ofrod 12. Amovement actuator mechanism 24 is rotatably mounted with respect to thebody 20. The movement actuator mechanism serves to cause the movement of thebackstop 14, to be described hereinafter.Body 20 comprises a barrel, or handle 26, which includes an aperture (not shown) extending at least partially therethrough. Barrel 26 is fixedly attached to end 22 ofrod 12.

As shown in FIG. 1, themovement actuator mechanism 24 is shown as aknob 28, anaxle 30, and acap nut 32.Movement actuator mechanism 24 is rotatably mounted tobody 20 by bearingblock 34. Themovement actuator mechanism 24 also includes the internal mechanism withinbody 20 that is used to cause movement of thebackstop 14 from the remote position ofbody 20. The backstop adjustment mechanism, as shown in FIG. 1, is made of chrome-plated brass.

FIG. 2 is a side view showing the surgical laser backstop instrument 10. As can be seen, backstop 14 is a rather thin titanium surface that is pivotally mounted at 18 torod 12.Backstop 14 is movable for a ninety degree (90°) range of motion. This allows thebackstop 14 to be movable between a position in which thebackstop 14 is aligned with the longitudinal axis ofrod 12 and a position in which thebackstop 14 is transverse, in position 40, to the longitudinal axis ofrod 12. As shown in FIG. 2,wire 42 extends outwardly from the interior ofrod 12 and is fastened to backstop 14 at a position adjacent to thepivot point 18.Wire 42 passes through a longitudinal bore extending throughrod 12. The forward and backward movement ofwire 42 causes the pivotal movement ofbackstop 14 throughout the range of motion illustrated in FIG. 2. Also, in FIG. 2, it can be seen that theknob 28 is circular and is located at the rearward portion ofbody 20.

FIGS. 3 and 4 show, in detail, the internal mechanism of themovement actuator mechanism 20. FIG. 3 shows rackassembly 50 which is located and positioned withinbody 20. As can be seen, a pair ofwires 52 and 54 are fastened toattachment point 56 onrack assembly 50. In comparison with the instrument illustrated in FIG. 2, thewire 42 is actually a pair ofwires 52 and 54 extending through parallel bores inrod 12. These wires also extend through the aperture ofbody 20.

FIG. 4 illustrates another aspect of themovement actuator mechanism 24. FIG. 4 shows an isolated end view of theknob 28,axle 30, andcap nut 32. Importantly, apinion gear 60 is interposed between thecap nut 32 and theknob 28.Pinion gear 60 is positioned within the interior ofbody 20 and engages the teeth ofrack assembly 50.Pinion gear 60 is connected toknob 28 such that the rotational movement of theknob 28 causes a corresponding rotational movement of thepinion gear 60. In combination with therack assembly 50, the movement of thepinion gear 60 causes backward and forward movement of therack assembly 50. The backward and forward movement of therack assembly 50, therefore, causes a corresponding backward and forward movement ofwires 52 and 54. As thewires 52 and 54 are drawn backward and forward, thebackstop 14 is, as a result, moved about its pivoted axis between the positions illustrated in FIG. 2. The amount of angular movement ofbackstop 14 is controlled by the amount of rotation applied to theknob 28. Referring to FIG. 2, a stop 70 will abut a surface ofrod 12 when thebackstop 14 reaches position 40. This serves to limit the range of movement of thebackstop 14 and serves to prevent the further rotation of theknob 28.

FIG. 5 illustrates an alternative embodiment of the present invention. FIG. 5 shows the surgicallaser backstop instrument 100 havingrod 102, backstop 104,movement actuator mechanism 106, and asmoke evacuation mechanism 108. For the most part, the configuration of the embodiment of FIG. 5 is identical to that described in connection with FIGS. 1-4. Importantly, however, the embodiment of FIG. 5 incorporates the smoke evacuation mechanism for the removal of smoke produced as a result of the laser surgery. Insofar as smoke is generally produced at the area ofbackstop 14 as a result of the laser surgery, thesmoke evacuation mechanism 108 serves to draw the smoke from within the peritoneal cavity through therod 102 and outwardly from the end of theinstrument 100. Specifically, thesmoke evacuation mechanism 108 includes an additional smoke evacuation bore 110 which extends longitudinally throughrod 102. Smoke evacuation bore 110 has an opening at 112 generally adjacent thebackstop 104. Thebody 114 of thebackstop adjustment mechanism 106 similarly has anaperture 118 extending therethrough. Theaperture 118 communicates with thebore 110 and opens at theexterior 120 of thebody 114. Avacuum pump 122 is connected bysuitable means 124, such as tubes, hoses, or other means.Vacuum pump 122 produces a small vacuum that serves to draw the smoke from the area aboutbackstop 104 into theopening 112, through the evacuation bore 110, through theaperture 118, and out through theexit opening 120.

FIG. 6 is an end view of theinstrument 100. As can be seen,rod 102 has a circular configuration. Thebackstop 104 haslines 130 and 132 attached thereto.Lines 130 and 132 pass throughbores 134 and 136 in therod 102. The smoke evacuation bore 138 opens as illustrated in FIG. 6.

The present invention offers a number of advantages not found in the prior-art techniques of laser backstops in laparoscopy and laser surgery. In prior-art techniques, the backstop was a fixed, solid rod. In actual use, this makes it difficult to place the backstop along the contour of the to-be-removed adhesion. During surgical procedures, it is necessary for surgeons to utilize the laser for a portion of the adhesion, to remanipulate the backstop, to reactivate the laser, and carry out a number of steps in order to properly attack a single adhesion. On the other hand, by the proper adjustment of the adjustable laser backstop of the instrument of the present invention, the backstop can be placed so as to offer a continuous laser backstop along the length and contour of the adhesion in the peritoneal cavity. This greatly increases the ability to surgically remove the adhesion through laser technology.

The present invention also offers a longer backstep for laser surgery. Since it is possible to angularly adjust the backstop relative to the rod, a longer backstop can be utilized in the surgery. This permits a longer and more continuous attack of the adhesion during the laser surgery.

Another advantage of the present invention is that the utilization of the smoke evacuation bore removes the smoke produced in the peritoneal cavity during the laser surgery. In prior-art techniques, this smoke would tend to obscure or blur the image produced through the laparoscope. By the removal of the smoke during the surgical procedure, the laparoscopic image remains clear with less obscuration. The smoke will simply be drawn through the evacuation bore and from the peritoneal cavity.

The foregoing disclosure and description of the invention is illustrative and explanatory thereof, and various changes in the size, shape, and materials, as well as in the details of the illustrated construction, may be made within the scope of the appended claims without departing from the spirit of the invention. This invention should only be limited by the appended claims and their legal equivalents.

Claims (18)

I claim:

1. A surgical laser backstop instrument comprising:

an optically nontransmissive rod;

a backstop pivotally connected to one end of said rod, said backstop comprised of a non-reflecting material, said backstop movable between a position in which said backstop is aligned with the longitudinal axis of said rod and a position in which said backstop is transverse to the longitudinal axis of said rod; and

backstop adjustment means mounted to the other end of said rod, said backstop adjustment means for controlling the movement of said backstop between said positions.

2. The instrument of claim 1, said rod coated with a non-reflective material.

3. The instrument of claim 2, said rod coated with titanium material.

4. The instrument of claim 2, said rod having a length greater than twelve inches.

5. The instrument of claim 2, said rod having a diameter of thirteen sixty-fourths of an inch or greater.

6. The instrument of claim 2, said rod havig an evacuation bore extending longitudinally therethrough.

7. The instrument of claim 6, said surgical laser backstop instrument further comprising:

smoke evacuation means connected to one end of said evacuation bore opposite said backstop, said smoke evacuation means for drawing smoke through said evacuation bore.

8. The instrument of claim 1, said backstop comprising a first section of titanium-coated material having a width equal to or less than the diameter of said rod.

9. The instrument of claim 1, said backstop extending outwardly for a distance greater than seven-tenths of an inch from the end of said rod.

10. The instrument of claim 1, said backstop adjustment means comprising:

a body connected to said other end of said rod;

a line fastened at one end to said backstop and extending through said rod; and

movement actuator means connected to the other end of said line, said movement actuator means connected to said body for controlling the pivotal movement of said backstop.

11. The instrument of claim 10, said body comprising a barrel having an aperture extending at least partially therethrough, said barrel fixedly attached to the other end of said rod.

12. The instrument of claim 10, said line comprising a wire connected at one end to said movement actuator means and at the other end to said backstop, said wire extending through a longitudinal bore in said rod.

13. The instrument of claim 12, said line comprising a pair of wires extending through parallel bores in said rod.

14. The instrument of claim 10, said movement actuator means comprising:

a knob rotatably mounted to said body, said knob for manually controlling the positioning of said backstop;

a rack assembly placed within said body and connected to the other end of said line; and

a pinion gear engaging said rack assembly and connected to said knob such that rotational movement of said knob causes a corresponding rotation of said pinion gear, said rack assembly movable relative to the rotational movement of said pinion gear.

15. The instrument of claim 10, said surgical laser backstop instrument further comprising:

smoke evacuation means connected to said body, said smoke evacuation means for drawing smoke from adjacent said backstop, said body having an aperture extending therethrough, said rod having an evacuation bore with an opening adjacent the pivotal connection of said backstop to said rod, said aperture of said body communicating with said evacuation bore, said smoke evacuation means including a vacuum connected external of said surgical laser backstop instrument.

16. A surgical laser backstop instrument comprising:

an optically nontransmissive rod;

a backstop pivotally mounted on one end of said rod, said backstop comprised of a laser non-reflective material, said backstop movable between a position in which said backstop is aligned with the longitudinal axis of said rod and a position in which said backstop is transverse to the longitudinal axis of said rod;

backstop adjustment means mounted at the other end of said rod, said backstop adjustment means for controlling the pivotal movement of said backstop relative to said rod; and

smoke evacuation means extending through said rod, said smoke evacuation means for the removal of smoke at an area adjacent said backstop said smoke evacuation means comprising:

a bore extending through the interior of said rod, said bore opening at the end of said rod adjacent said pivotal connection of said backstop with said rod; and

a vacuum pump communicating with said bore at the other end of said rod, said vacuum pump for drawing smoke through said bore.

17. An improved surgical laser backstop instrument having a backstop of the type connected to a surgical rod, said improvement comprising:

a laser non-reflective surface pivotally connected to said surgical rod, said surface movable between a position longitudinally aligned with said surgical rod and a position transverse to the longitudinal axis of said surgical rod; and

backstop adjustment means mounted to the other end of said surgical rod for controlling the pivotal movement of said surface.

18. The instrument of claim 17, said surface being coated with titanium, said surface having a length of greater than seven-tenths of an inch and a width not greater than the diameter of said surgical rod.

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